Longitudinal study on factors affecting assertiveness among preceptors of novice nurses

Purpose: This study aims to understand the assertiveness of preceptors of novice nurses and factors affecting the assertiveness through a longitudinal perspective. Methods: Anonymous self-rating questionnaire surveys were administered to 1292 preceptors working in participating city and university hospitals across Japan (August, 2013 (baseline) and March, 2014 (second survey)). The surveys had question items from the Japanese version of the Rathus Assertiveness Schedule (J-RAS, 30 items), demographic details of the participants, evaluation of novice nurses by preceptors, instruction framework, selfevaluation of preceptors, working environment, and a burnout inventory (Japanese version of the Maslach Burnout InventoryHuman Services Survey, 22 items). Bivariate analyses (T-tests and one-way analysis of variance) were conducted using assertiveness of the second survey as the objective variable, and other items of the baseline survey as explanatory variables. Selecting variables with p values smaller than 0.2 obtained in the bivariate analysis as explanatory variables, a multiple linear regression analysis (Stepwise method) was conducted. For the analyses, we used a statistics analysis software, SPSS Statistic 22. Results: Choosing 836 valid respondents of the baseline survey as a cohort group, we repeated the survey 8 months after the baseline survey to identify the factors affecting the assertiveness of preceptors of novice nurses. Excluding 62 who had missing values in the question items for assertiveness, 472 participants who were followed were included in analyses. As the results, following factors were found to affect the assertiveness: thinking that ‘they make rapid decisions’, and that ‘they are valuable as others’. Further, participants who have higher total burnout scores had lower assertiveness. Adjusted coefficient of determination was 0.153. Discussion: It can be inferred that the assertiveness of preceptors is higher than that of novice nurses measured by the J-RAS used in this study, and lower than that of administrative nurses. The assertiveness of preceptors was higher among participants who evaluated themselves positively, thinking that ‘they make rapid decisions’, and that ‘they are valuable as others’. It was also found that higher ‘total burnout scores’ was a factor that lowers the assertiveness. These findings suggest that a positive self-evaluation improves assertiveness and helps to prevent burnou

Evaluation of patients who underwent percutaneous transhepatic portal vein embolisation by Tc-99m GSA scintigraphy

Purpose: To analyse the correlation between the fold change in residual liver volume (RLV) and residual liver uptake at 15 (RLU15) before and after percutaneous transhepatic portal vein embolisation (PTPE). Material and methods: Between August 2010 and December 2016, 20 patients who underwent PTPE were retrospectively selected. Before and three weeks after PTPE, contrast-enhanced computed tomography (CECT) and Tc-99m GSA scintigraphy were performed to analyse the fold changes in RLV and RLU15, respectively, as well as their correlation. Results: After PTPE, a significant increase was observed in the RLV (before: 464 ± 99 ml; after: 573 ± 118 ml, p = 0.004) and the RLU15 (before: 11.0 ± 2.9%; after: 17.7 ± 3.8%, p = 5 × 10-7). The fold increase of RLV and RLU15 in all patients was 1.25 ± 0.15 and 1.66 ± 0.33, respectively. No significant correlation was observed in the fold increase in both RLV and RLU15 (r = 0.14, p = 0.66). In patients no. 3 and 9, who were outliers, the increase in RLV was minimal and RLU15 increased greatly, and these 2 patients underwent radical hepatectomy after PTPE. Conclusions: No correlation was observed between the fold increase in RLV and RLU15 before and after PTPE. In order to accurately evaluate the residual liver function, it should be considered necessary to evaluate not only by morphological CECT volumetry, but also by functional outcome of Tc-99m GSA scintigraphy. Residual liver volume may not necessarily reflect RLF. It may be possible to improve the radical resection rate by detecting the potential increase of RLF with RLU15 of Tc-99m GSA scintigraphy

看護学臨地実習指導者の自己教育力とキャリアコミットメントの関連

　本研究は，看護学生の実習指導にあたる指導者の自己教育力とキャリアコミットメントとの関連を明らかにすることを目的とした．　関東甲信越・東海地域の300 床以上の病院の指導者1032 人を対象として，2018 年1 月～ 3 月に自記式質問紙による郵送留置法で調査を行った．　回収数は 811 部（… 回収率 78.6％）であった．指導者の自己教育力尺度の回答に欠損があるもの，職位をもつ指導者を除く499 人（有効回答率61.5％）を分析対象とした．指導者の平均年齢37.9 ± 7.2 年，平均臨床経験年数15.0±6.5 年，平均指導者経験年数5.8±5.0 年，指導者講習会受講後指導者経験年数3.8 ± 4.3 年であった．　本研究における指導者の自己教育力尺度のCronbach\u27sα 係数は0.91 であった．　本研究の自由度調整済み決定係数は0.25 であった．重回帰分析（ステップワイズ法）の結果，指導者の自己教育力とキャリアコミットメントは，最も強く関連していた．さらに，自ら希望して指導者講習会を受講した者，専任体制で実習指導を行っている者，専門誌を購読している者の自己教育力が高いことが明らかになった．　この結果から, 指導者の自己教育力を高めるためには，指導者の看護の専門性への愛着や思い入れであるキャリアコミットメントを指導者自身が認識し，高められるような働きかけが重要であると考える

Amantadine can Ameliorate Lower Urinary Tract Dysfunction and Nocturnal Polyuria in Patients with Parkinson Disease and Vascular Parkinsonism

Background:Amantadine is a drug used for patients with Parkinson\u27s disease (PD) and vascular parkinsonism (VP). These patients often have lower urinary tract symptoms (LUTS) and nocturnal polyuria (NP). Thus, we investigated the effect of amantadine on these in parkinsonian patients.Methods:Twenty-two patients with LUTS, including 13 with PD and nine with VP, were recruited. We performed a urinary questionnaire, frequency-volume chart, and residual urine (RU) measurement before and after daily administration of 150 mg and 300 mg amantadine.Results:Before amantadine administration, mean daytime urinary frequency was 9.07(standard error [SE], 0.64), nighttime urinary frequency 2.89 (0.24), urinary urgency per week 24.2 (6.69), urge incontinence per month 15.1( 9.94), urine volume per void 145.6( 12.6) mL, and residual urine volume 12.5( 6.30) mL. After daily 150 mg amantadine administration, mean daytime and nighttime urinary frequency, urinary urgency, and urge incontinence decreased to 6.9( 0.42), 1.97( 0.21), 13.0( 3.58), and 14.2( 10.2), respectively, and urine volume per void increased to 174.1( 11.3) mL. NP( N=8) was ameliorated in six patients. No patient had side effects. After daily 300 mg amantadine administration( N=8), mean daytime and nighttimeurinary frequency, urinary urgency, and urge incontinence decreased to 6.90 (0.33), 1.69 (0.10), 5.88 (1.61), and 2.31 (0.61), respectively, and urine volume per void increased to180.2 (15.0) mL. NP (N=4) was ameliorated in two patients. One patient developed hallucination, and two patients developed flashing sensation.Conclusion:Amantadine has beneficial effects on LUTS and NP in patients with VP and PD

Development of a mugineic acid family phytosiderophore analog as an iron fertilizer

Iron (Fe) is an essential nutrient, but is poorly bioavailable because of its low solubility in alkaline soils; this leads to reduced agricultural productivity. To overcome this problem, we first showed that the soil application of synthetic 2′-deoxymugineic acid, a natural phytosiderophore from the Poaceae, can recover Fe deficiency in rice grown in calcareous soil. However, the high cost and poor stability of synthetic 2′-deoxymugineic acid preclude its agricultural use. In this work, we develop a more stable and less expensive analog, proline-2′-deoxymugineic acid, and demonstrate its practical synthesis and transport of its Fe-chelated form across the plasma membrane by Fe(III)•2’-deoxymugineic acid transporters. Possibility of its use as an iron fertilizer on alkaline soils is supported by promotion of rice growth in a calcareous soil by soil application of metal free proline-2’-deoxymugineic acid